<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">

        <div class="layui-form-item">
            <label class="layui-form-label">周转项目</label>
            <div class="layui-input-block">
                <input type="text" name="name" class="layui-input" lay-verify="required" placeholder="请输入周转项目"
                    value="{$row.name|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">周转日期</label>
            <div class="layui-input-block">
                <input type="text" name="date" data-date="" data-date-type="date" class="layui-input"
                    lay-verify="required" placeholder="请输入周转日期" value="{$row.date|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">账单金额</label>
            <div class="layui-input-block">
                <input type="text" id="bill_amount" name="bill_amount" class="layui-input" lay-verify="required"
                    placeholder="请输入账单金额" value="{$row.bill_amount|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">周转金额</label>
            <div class="layui-input-block">
                <input type="text" id="capital_amount" name="capital_amount" class="layui-input" lay-verify="required"
                    placeholder="请输入周转金额" value="{$row.capital_amount|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">到账金额</label>
            <div class="layui-input-block">
                <input type="text" id="arrival_amount" name="arrival_amount" class="layui-input" lay-verify="required"
                    placeholder="请输入到账金额" value="{$row.arrival_amount|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">手续费</label>
            <div class="layui-input-block">
                <input type="text" id="service_charge" name="service_charge" class="layui-input" lay-verify="required"
                    placeholder="请输入手续费" value="{$row.service_charge|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">补充金额</label>
            <div class="layui-input-block">
                <input type="text" id="supplement_amount" name="supplement_amount" class="layui-input"
                    lay-verify="required" placeholder="请输入补充金额" value="{$row.supplement_amount|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">补充总计</label>
            <div class="layui-input-block">
                <input type="text" id="supplement_sum" name="supplement_sum" class="layui-input" lay-verify="required"
                    placeholder="请输入补充总计" value="{$row.supplement_sum|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">备注</label>
            <div class="layui-input-block">
                <textarea name="remark" class="layui-textarea" placeholder="请输入备注" value="{$row.remark|default=''}"></textarea>
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>
    </form>
</div>